one latte at a time

Breastfeeding Twins in NICU

**This post contains breast feeding pictures… if you are at all not interested, don’t read further!**

Hands down, the most common question I am asked is if I breastfeed or not – typically as a statement, “You don’t breastfeed…right?” Yes, yes I do. Let me preface this: singleton, twins, or more… choosing to breastfeed is a very personal choice and I truly believe that if you’re baby’s belly is full, fantastic. Whatever you choose to do – exclusively breastfeed, pump and give bottles, formula supplementation, or exclusively give formula – you are making a choice that is best for you, your baby, and your family. You have my support all the way (not that you need it because you don’t need anyones approval!)

For me, I have always wanted to breastfeed… and when I knew I was going to have preemies (you can see more about that here, here, and here) it became even more important to me.

Breastfeeding in NICU was a whole differente experience than when we got home. If you are in NICU or know you will be, this will hopefully give you a good starting point. If you have any questions, don’t hesitate to contact me!

SO let’s start from the beginning.

2 weeks old

Preparing:

When I went on bedrest at 19 weeks due to vasa previa (you can read more about that here), I went a little crazy planning… I scoured the internet for everything I could learn on how to breastfeed twins. I read countless blogs on the logistics of how to get two babies from cribs/swings/floor to nursing and back to said place. I was dyyyying to read everyone’s experiences, what worked, what didn’t work, could you do it independently or did you have to have someone there to help, what pillow was best, etc. I met with the lactation consultants multiple times to try to learn everything I could…. I have to say reading and watching videos of other women who had been there, done that – priceless. And I practiced. Yep. I am a planner and I like to be prepared. (you can laugh…preemie twins = nothing you can really prepare for…let’s be honest. babies, in general – you can’t reeeally prepare for).

Piper’s NG tube feeding

In the beginning:

The girls were born at 31 weeks and 3 days, weighing in at a whopping 3lb 3oz and 3lb 13oz.

They needed critical care in NICU in the beginning so I wasn’t allowed to even attempt to nurse. They were getting all of their nutrition through IVs in the beginning and then had OG and then NG tubes… so I took it as my job to pump.

I was still in the operating room when I told the nurse that I needed a pump for me to use as soon as I got back to recovery. I wasn’t kidding. I had been through this with my sister when Parker was in NICU so I knew how the hospital pumps worked.

I finally got hooked up probably 45 minutes after surgery and pumped 5oz. I was shocked. So were the nurses… I have no idea why that happened, but it did. That only happened one time…so don’t get too excited.

I pumped every 2-3 hours around the clock then. This was one thing I could do for my little peanuts while they were trying to grow and get healthy. It’s a weird feeling not really feeling like ‘mom’ when you have other professionals who are really caring for your babies… asking for permission to change a diaper, hold a hand, hold your baby, etc. But pumping? That I could do and felt like it gave me a purpose.

Schedule:

The girls were on a 3, 6, 9, 12 schedule.. we would do body temp, diapers, and feeding on that schedule around the clock. So I tried to pump 30 minutes beforehand around the clock too (2:30, 5:30, 8:30, 11:30) so I could eventually use my milk in their tubes. With having two babies on this schedule, it took about 1.5 hours and we would only get an hour (if that) before we had to begin pumping again. It was exhausting. More than exhausting. I never missed a feeding and Zach was there for most of them too.

Location:

I quickly learned when my second milk came (what most people refer to when they ask “Has your milk come in yet?”) that if I tried to pump away from the girls, I wouldn’t get anything. We were so blessed to be able to stay in a ‘Parenting Room’ in the hospital… it was in the maternity wing and was just big enoug for a bed, a pull out chair for Zach and a shower. The girls were sick enough in the beginning that we were able to stay based on how critical they were. Then as they got stronger, we were able to stay because I was ‘breast feeding’ – aka pumping and we were there for every feeding through the night. The nurses had tried to convince me to try to pump in our room for just one of the feedings so that I could get a little sleep. It didn’t work. I just wouldn’t get anything. I tried to play videos and scroll through pictures while I did that and if you are in a situation where you can’t be in the NICU 24/7, I would highly suggest doing that. But, for me, I learned that being in their room made all the difference in the world.

Piper and Lila.. first time tandem nursing and they held hands

Target Practice:

The goal at this stage was to place them close enough on my chest and they would try to smell and open their mouth… simple enough, but for teeny babies who weren’t supposed to be in this world yet, it was a miracle.Piper was 7 days old before I was allowed to ‘target practice’ with her and Lila was 11 days. They were too small, too weak, and not skilled enough yet to really nurse… that whole ‘suck, swallow, breathe’ thing was just too hard. It took up too much energy and they would stop breathing, but we got to practice and they still got their nutrition through IVs and tubes. I will NEVER forget this moment with them… so many tears of joy. I never thought I would get to experience this.

The other goal with target practicing is that as they get a little stronger and able to stay awake for more than 15 seconds, when they would start to lick/smell around, we would feed them through their tube so that they could start to correlate breast=milk=fully belly.

Oral Care:

In the beginning, one thing I was able to do was oral care with my colostrum. Those first few days I got drops. It was so discouraging, but I had nurses who were huge advocates and really supported me. So I would take a cotton swab, get what tiny bit of colostrum there was, and rub it on the girls gums, tongues, and cheeks. They LOVED it, and so did I .

What you need – Breastfeeding:
– My Brest Friend (Yes, this is what it’s called…and yes, I hate the name as much as you) for Twins: I used this pillow in the hospital and at home when I did night feedings in the nursery by myself. They have one for singletons, but this one was clutch for two babes. I loved that this had a back support, although I always put a pillow behind my back as well. It also has a pocket that I kept a water bottle in. Most importantly though, it has ridges on it so that I could pick one baby up (or have someone hand them to me), get them latched on, then pick up the other baby to get that one latched on.

– Two blankets: Because the girls were all of 3-4lbs when I started nursing in NICU, they were too tiny to rest on the pillow and be able to reach my breast. So I used blankets to prop them up. I love these from Aden + Anais because they’re so light but big enough to roll up and have some good hold to them.

– Water: Hoooooly moly there isn’t enough water in the world for nursing two babies. I drank a gallon per day and that significantly helped with my supply and not feeling hungover.

–TwinZ Nursing Pillow– I didn’t use this in the hospital because of the design and the chairs just didn’t work well… but this was HUGE for when I got home. I used this ALLL th time when nursing on the couch. I never felt comfortable enough to use this by myself, but I used it when someone was there to help me. Because Zach was on summer break, this was frequently. It is much more ‘pillow-y’ and comfy to use and I did love the back support.

– Nipple Shieldf – If you have preemies, you will likely need these… the girls’ mouths just weren’t big enough to latch effectively and these helped significantly. Make sure to work with the lactation consultant to make sure you have the right size and they can teach you tricks to use them… and to fade them out because you do not want to be on these forever.

Best Friends

What you need – Pumping:
– Hospital Pump: I was so lucky to be able to use the hospital pump the entire time the girls were in NICU because we were staying there too. I had one in our parenting room and one in each of the girls room. Ask your hospital if you can ‘borrow’ it while you are there.

– Hands free bra: I went a week before ordering one on Amazon and seriously don’t know how I survived before -that’s questionable whether I was really surviving. There was one night at 2:30 am, after Lila’s lung had collapsed and I had spent the majority of the day crying…I was exhausted. I was pumping, accidentally fell asleep and spilt 3oz of milk. Disaster. The world was ending. Take my advice. GET ONE OF THESE NOW. I used this one, and it was fine…but I think I would have wanted a zip up one just because through the exhaustion and poor lighting it typically took me 2 times to get it snapped right. I’ve heard a lot of good things about this one too.

– Lansinoh Thera Pearl 3-in-1 Hot or Cold Breast Therapy: I received these as a shower gift and honestly almost returned them. I had no idea what they were for and didn’t think I’d use them. I found out when the girls were about 2 weeks old that I had Raynauds…I had been having ridiculous pain and honestly thought about throwing in the towel. My nipples would blanch and turn white after getting out of the shower or after the girls would be done nursing and it was so p.a.i.n.f.u.l. After finally talking to a nurse who had experienced the same thing, we discovered I had Raynauds. These therapy pads were AHHHHMAZING. I(let’s be honst – Zach) could microwave them for 20 seconds, and I could keep them on while pumping, or throw them on after the girls were done)and it eased my pain. These also decreased time needed for pumping – double bonus.

– Motherlove Nipple Cream: This stuff saved my life. However, after the girls came home, I used coconut oil almost exclusively. Two babies sucking on your nipples… mmm hm . Need I say more? You never get a break and your nipples are constantly being sucked on. Let alone preemies who aren’t very good at latching and are trying to learn. Just live in it.

**Use the lactation consultants and any time you have while you are in NICU to learn absolutely everything you can while you have nurses and staff there to help you. Try to do it independently with the nurse there to help if you get stuck in a position you can’t get out of. When you get home, you need to be a pro at this… and practice makes perfect!!

If you’ve been there, done that, please leave any suggestions I haven’t mentioned in the comments section or email me – or link up so there are multiple resources!

If you are in the midst of all of this – it WILL get easier and you WILL get through this. They will get stronger, you will get stronger, they will get better and you will get better. It is hard work and it takes practice, but if you keep at it, you absolutely can do it!!